That title sounds like something B.B. King might sing about after visiting the ER. Ah, if only that were true. Well, I now know the source of most of my knee issues during the rehab. Or I should say, the source has now been confirmed.
A CT scan revealed that the bone graft from the osteotomy is not attached to my tibia. In medical terms, there’s non-union of the graft and the bone. The only reason the graft hasn’t floated away is because the two Home Depot screws are holding it together. Of course, these are the same screws that really ache and that I desperately want removed from my leg. Not surprisingly, this poses a major dilemma, which I’ll address in a moment.
Anyway, this discovery/confirmation explains my struggles to bend at the correct focal point; that my knee generally feels fine, but mechanically it functions differently, something I struggled to explain to folks, including Dr. T and Dr. Berman. I almost feel like the osteotomy defect has cheated me out a “true” ACI rehab experience. Ok, not really.
At least I know what’s wrong. And like the ending to the old G.I. Joe cartoons, “knowing is half the battle.”
So what does this mean? What’s next? Right now, I’m not sure. Presumably, I’ve got 3 choices: (1) do nothing, which means leaving in those f*cking screws and having an unattached bone wedge; (2) undergo a bone graft to fill in the “area of non-union” between my tibia and the wedge; or (3) see if the screws and the entire bone graft can be removed. None of these options is very good. All of them have drawbacks.
First, doing nothing means learning to live with the uncomfortable screws and a really sensitive shin. Plus, I can’t imagine having an unattached bone wedge inside my leg is a good thing.
Next, a bone graft means another major surgery. And several more painful months of recovery. And another several months of putting my life on hold. Not to mention there’s no guarantee the bone graft will work.
As for the final option, I have no clue whether it’s possible to remove the unattached bone wedge (along with the screws). In my non-medical mind, if it’s not attached, why not “take it out?” That seems logical, right? Besides, I don’t need the osteotomy anymore. The ACI graft has sufficiently matured, eliminating the need to alleviate the pounding absorbed by the patella. True, the osteotomy would alleviate pressure long-term, thus minimizing the risk that I’d re-injure my injury-prone patella. But since I don’t expect to play competitive sports anymore, I think the odds of a future injury are minimal.
Sometime soon I’ll discuss these options with Dr. T. And then I’ll seek out another opinion to be safe. Stay tuned.
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3 comments:
I'm sorry to hear about your osteotomy problems. I hope that you and your orthopedic surgeons can find a good solution.
I know your road to recovery has been long. Thanks for continuing to share your journey. I swear sometimes I feel like you are reading my mind--you are able to express the things I don't know how to say (or feel).
My ACI, ACL and meniscus transplant was over 9 months ago--while I am still making progress, my OS has just scheduled me for an arthroscopy in two weeks for ACI overgrowth and possible partial menisectomy :(
Good luck to you. I look forward to hearing your progress!
-Lynn
Hey Lynn. Good to hear from you. Yeah, this wasn't where I hoped to be at the 15-month mark. The irony is that the knee seems to be fine, but the shin is jacked up. Of course, it could be that the osteotomy is preventing me from learning the knee's condition. Assuming I undergo some sort of bone graft surgery, I'm sure the OS will scope the knee at the same time, clean out any overgrowth and remove any scar tissue, etc. That's really the only way to judge whether the cloned cartilage filled in.
Sorry to hear about your additional surgery, though overgrowth isn't terribly uncommon. As for the partial menisectomy, have you looked into whether they can insert an artificial one? That apparently is the new "rage" in scopes.
Keep in touch.
Jim
Oh, I hope you don't have to go through another big surgery (although you do keep me entertained with your clever blogging!)
I'm hoping that a "clean up" is just what I need.
I haven't looked into the an artificial meniscus. If you remember, this is a transplanted meniscus--the bone plug part seems to be well incorporated but the meniscus is partially extruded into my lateral gutter. I don't think that it is causing any additional problems and seems to still be a "cushion" to my femoral condyle ACI site. I guess I'll have to wait and see what it looks like in there.
Keep blogging.
Lynn
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